Car insurance claim can be rejected if vehicle tyres are not roadworthy!

Car insurance claim can be rejected if vehicle tyres are not roadworthy!

Tyres not roadworthy

Can your vehicle insurance claim be rejected if your vehicle is not in a roadworthy condition? If we carefully consider this question we would have to agree that roadworthiness is indeed a fair expectation from the side of the insurer.

The insurer insures a roadworthy vehicle and provides cover for such a vehicle and the risks to the reasonable operation of such a vehicle. If the damage is caused by an unlicensed driver or a drunk driver – the insurer may reject the claim. It only seems reasonable that the insurer could expect the car to be driven in a roadworthy condition and with tyres that provide safe protection on the road!

The answer to this question is however not as simple. There have been differing decisions by the Ombudsman on this matter. It is important to consider the facts in each scenario and establish whether the condition of the tyres was in fact a direct cause of the accident and the damage to the car.

We would like to consider one example where the tread on tyres were considered an important contributing factor to the accident:

Example: Rear tyres did not have a proper tread situation.

Facts: The insured was travelling from Cavendish Square in Claremont, Cape Town, to his home in Fish Hoek, along the M3 freeway.

Just before the Tokai turnoff, a drunken pedestrian was illegally on the freeway and stumbled and ran into the road just missing a 4 x 4 Toyota. The insured swerved, applied the brakes heavily to try and avoid the pedestrian, but he ultimately collided with the pedestrian who survived the collision. The insurer rejected liability because both rear tyres had tread below the legal limit, and it was a condition of the policy that a vehicle had to be in roadworthy condition. The insured did not accept the aforesaid allegation, and the insurer then requested the AA to supply it with a report, which confirmed that both rear tyres were found to be unroadworthy.

Ombudsman’s response:

The policy issued to the insured contained a specific condition that the vehicle be kept in a road worthy condition at all times in terms of the Road Traffic Ordinance. The tyre tread depth did not meet the requirements. The insurer’s decision was not based entirely on the policy condition, but also on the fact that the collision may have been avoided and the damages lessened had the vehicle tyres been in a good condition. Based on the facts, the Ombudsman concluded that the insurer was entitled to maintain the rejection.

[Source: Ombudsman Annual Report 2003]

We would like to urge all vehicle owners and policyholders to attend to the roadworthiness of their vehicles and to view the Arrive Alive website for more info on “Tyres and Road Safety”

9 thoughts on “Car insurance claim can be rejected if vehicle tyres are not roadworthy!”

My son is in dispute with the Ombudsman at the moment over this exact scenario. There is no proof that the one worn tyre led to the crash which happened to the driver of my son’s insured fleet vehicle. Only the insurer’s engineer has made the claim that the crash was caused by a skid. No weather report is available either. The crash was late at night at a sharp right turn. The driver remembers nothing about the accident which left him badly hurt. The police prosecuted him not my son. Is there a chance that there is a precedent that applies here?

Ok – I have a quite a bit to say about this, and I tend to get a bit heated when these topics are raised, so I will do everything in my power to restrain myself…

Let’s get one thing straight – Insurance companies (ombudsman, or not) tend not to apply this “rule of roadworthiness” universally. If a vehicle’s license disk is expired, it is “not roadworthy.”
If there is rust on the vehicle, it is”not roadworthy.” If the head-lamp does not work, it is “not roadworthy.” If a number plate has fallen off, it is “not roadworthy.”
In any of the above cases, if a parked vehicle is run into, the insurance will “pay out.” If the condition of insurance, is truly that the vehicle “must be roadworthy,” why do they not repudiate all claims on this basis?
Why are our premiums so high and why are the insurance service providers NEVER advertising this? It is typically included in the “fine print” on your policy.
If an insurance ad said: “We will insure your vehicle only if you drive it, if it is perfect, if you never make a mistake and forget to renew a license disk and only if it is never, ever your fault,” how may people would bother?

As an investigator with experience at more than 7,500 accident scenes, I have two things to add:

1. I have saved an insurance company over R1.5-million in just four cases, where drunken driving and/or “illegal drivers” were concerned.

2. I have attended THREE accidents, in ONE weekend, where ALL THREE involved drunken driving, ALL THREE drivers tested BY ME, and ALL THREE coincidentally from the same insurance company. I contacted the company and informed them of this, and offered my reports. They told me they would “get back to me,” but eventually paid out ALL THREE CLAIMS. Probably several hundred thousand rands’ worth!

At one stage, I offered ALL insurance companies that would see me a VERY LOW rate to use me/us to attend and investigate every accident, in order to immediately detect un-roadworthiness, drunken driving, “illegal drivers,” false damage claims, etc. Would you believe that NONE of the insurance companies opted for this, although the cost/gain model was highly beneficial to them – like millions in savings per year?

What was the reason I was given? Insurance companies “cannot afford for people to see or know that every accident will be investigated (properly) since this will result in many clients moving to the competition, where claims are paid out more easily!”

It seems there are two departments that are constantly at war in the insurance industry: Marketing and Claims. Marketing tells you “we’ll pay for anything at any time, under any conditions,” in order to get new customers, while the Claims department wants to repudiate all claims to ensure maximum profit. The balance between the two is a very fine line!

I also KNOW from experience that insurance companies will pay a “small claim,” like “R 100,000,” if their client has many vehicles insured with them, or vehicles of a very high value, since this is “cheaper than losing the client,” even where the claim would not typically be “paid out,” for the reasons mentioned. I have experienced this situation myself – since I represent very large corporate clients.

I also know that racing cars have “slick” tyres for a reason – they grip BETTER on dry roads. Grooves actually are a bad thing on dry roads, since they reduce the total road/tyre friction area.
So – on a dry road, the “braking efficiency” is improved by “smooth tyres.”

Obviously, the reverse is true on wet roads, but I saw no reference to weather in the prior posts – only reference to “roadworthiness.”

I am of the opinion that – if insurance companies are truly going to repudiate on the basis of un-roadworthiness – then my experience in the past indicates a violation of our constitutional right to be treated equally and fairly.

I think the insurance companies and the ombudsman is wrong, in this reference, since it is a known (and easily demonstrated FACT) that:

a) Not all insurance claims are treated equally.
b) Not all insurance customers are treated equally.
c) Repudiations are more prevalent in cases where the customers are “poorer” and cannot afford court cases.

You’d think that insurance companies would LOVE us – specialist at-scene forensic accident investigators – but you’ll be surprised to know that we are hardly ever used by the insurance industry.
But, those that DO use us, swear by us, and continue to refer cases to us. In conclusion, I need to explain that I am not just “angry at insurance for not using us,” since their clients often use us in any event.
The sad thing is that their clients must pay insurance to cover them, but then need to pay people like us to convince them to deliver in terms of the service offered!

Please can you assist.I had an accident on arainy day in wet weather on the N# Durban bound and the road was water logged. The insurance copmay has rejected the clain stating that my back tyres were not road worthy in some areas.My car aquaglided across the freeway and now they won’t pay out.

January 6, 2010 at 3:29 pm

admin

Hi Colleen,

we suggest you lodge a complaint at the Ombudsman for Short Term Insurance. Their mission states … “To resolve short-term insurance complaints, fairly, efficiently and impartially”

June 4, 2010 at 11:17 am

Michael

Dear Collen Khumalo

Please update on how you have resolved with the issue, i am currently going through the same experience where the insurance rejected my claims citing the tyre tread. They do not take into considerations that the weather was bad. It was so bad that there were many other accidents on the day and it was even in the paper citing how bad it was.

Please indicate how you came about to solving the problem

Many thanks

June 10, 2010 at 3:04 pm

Ace

Please assist. My insurance has rejected my claim due to back tyres below the legal limit. Now I hired a private assessor, who concluded that both tyres are not below the legal limit. Now i would like to find out who /(company) that could assist with a report that I can use to challenge the insurance company.

June 6, 2011 at 4:46 am

Ettienne

I have a question. I had the same situation (car written off and claim rejected because of unroadworthy tyres). When I bought the car, I took out top up insurance from Zurich. According to their contract, they will pay out in the event of unintentional violation of the comprehensive insurance’s terms and conditions. I cannot find any information regarding this. Does anyone know how to go about initiating this claim. I would like some advice before I get myself in a legal bind.

August 31, 2012 at 8:21 pm

Surprise Ngobeni

i received a rejection latter because my tyres were noit rpadworthy but i strongly believe that my tyres were still in good conditions and roadworthy. want must i do?

July 12, 2015 at 8:55 pm

Phale

It also important to know that if the Insured didn;t know the tyre condition the Insure would find it difficult to reject a claim based on tyres this is so because the concept of Insurance needs to test the Insured’s state of mind and not the Insured’s negligence of driving vehicles with worn tyres